As the global battle against COVID-19 rages on, Malaysia’s concerted effort in stemming the spread is commendable. This study characterized the epidemiology of COVID-19 aiming towards understanding the disease in a local setting for better preparation and management. A nation-based e-COVID reporting system was used to collect data on laboratory-confirmed COVID-19 cases in Kelantan from January to July 2020. Information from investigation reports was also reviewed. Analyses comprised of the estimation of incidence and case-fatality rate, summary of demographic and clinical characteristics including the age and sex distributions, construction of the epidemiological curve and choropleth map, and appraisal of healthcare usage. Multiple logistic regression was used to determine the risk factors for Intensive Care Unit (ICU) admission. A total of 166 cases reported in Kelantan until July 2020. Cases peaked during March before steadily declining and were concentrated in the capital. The age-adjusted incidence rate was 9.4/100,000 populations with a case-fatality rate of 2.4%. The median age was 37 years and 78% were male. The predominant symptoms were fever and cough while 25% of cases were asymptomatic. About 57% of cases were identified by active case detection and 97% had exposure risk. Potentially infected cases were isolated within a median of 7 days after exposure, even before the diagnosis. All cases were hospitalized with a median of 14 bed days, while 12% admitted to ICU, and 3% required mechanical ventilators. Significant factors for ICU admission were older age (AOR: 1.05, 95% CI: 1.02, 1.09, P = 0.001) and diabetes mellitus (AOR 4.55, 95% CI: 1.36, 15.25, P = 0.014). Although all ages appeared susceptible to COVID-19, older age and diabetic patients were more vulnerable. Kelantan’s targeted approaches of prompt identification and isolation of potentially infected individuals have been effective in limiting the transmission, allowing sufficient healthcare capacity in managing the pandemic.
Background: Human H5N1 infections are concerning as they are associated with severe disease and death. On 6 th March 2017, the Veterinary Department alerted the Health Department regarding the isolation of H5N1 virus in a dead domestic chicken in Kampung Pulau Tebu in Kota Bharu district, Kelantan. The objective of this paper is to describe the key strategies to prevent H5N1 transmission to humans during the outbreak in poultry in Kelantan. Materials and Methods:This was a cross sectional study used for the epidemiological investigation and public health response in human for the avian influenza outbreak in poultry. Public health response was in compliance with the Standard Operating Procedure for Potential Infectious Diseases. The strategies executed were emergency preparedness and contingency plan, public awareness and risk communication, interagency co-operation and collaboration and stakeholder support and commitment. Data were obtained from District Health Offices and the State Veterinary Department. Data entry and analyses were conducted using Microsoft Excel 2016Results: There were 6 districts and 36 foci with positive H5N1 results in poultry whereby 55450 poultry were culled and 17531 eggs were destroyed. The population at risk of 13385 individuals were screened and 23 were suspected to have Avian Influenza, 5 with ILI symptoms and 50 with mild URTI symptoms. Laboratory results for 23 samples that were negative for H5N1. A total of 330 healthcare workers and 184 veterinarian staff exposed to infected poultry were monitored for 10 days and were well. Biosecurity measures were undertaken by the state veterinary and health departments. Conclusion:The public health response was successful in preventing H5N1 transmission from poultry to human.
A dengue outbreak occurred in Pasir Mas District, Kelantan, Malaysia during 2010. We conducted an investigation to describe the clinical and epidemiological characteristics of cases, determine risk factors for transmission and recommend appropriate control measures. A dengue case was defined as an individual with acute febrile illness and two or more of the following symptoms: rash, arthralgia, headache, myalgia, retro-orbital pain, hemorrhagic manifestation or leucopenia. Environmental surveys were done to search for Aedes species. A matched case-control study was done. From 5 May to 12 Aug 2010, total 465 cases were identified, with male to female ratio as 1.2:1. Most cases (34%) belonged to 11-20 years old group, followed by those aged 21-30 years (14%). Cases were mostly students (40%) or rubber tappers (15%). Aedes aegypti and Aedes albopictus species were identified in the district while many cases resided in areas with Aedes index of more than 1% and breteau index of more than 5%. Risk factors for getting dengue infection were presence of discarded containers within household premises (adjusted OR = 15.1, 95% CI = 5.41-41.97) and not using protective measures (adjusted OR = 3.9, 95% CI = 1.21-12.55). Control activities focused on mass clean-up and health education campaigns in affected communities. As a conclusion, this outbreak involved active individuals, and contributed by presence of breeding containers and not using personal protective measures.
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